KADIN VE ERKEK DİYABET HASTALARININ AYAK TABAN DUYULARININ KARŞILAŞTIRILMASI

Yıl 2018, Cilt: 3 Sayı: 1, 29 - 37, 30.03.2018

Seyit Çıtaker Nihan Kafa İlhan Yetkin Nevin Atalay Güzel Zeynep Tuna Zeynep Hazar Kanık

Öz

Diyabet hastalarında
duyusal nöropati yaygın görülen komplikasyonlardandır. Kadın ve erkek fizyoloji
ve metabolizmaları farklıdır. Diyabet hastalarında cinsiyete göre duyusal
nöropatinin şiddetini karşılaştıran bir çalışma bulunmamaktadır. Bu çalışmanın
amacı, kadın ve erkek diyabet hastalarının ayak taban duyularını
karşılaştırmaktır. Çalışmaya 40 diyabet hastası ve 10 sağlıklı kontrol bireyi
alındı. Tüm bireylerde ayak tabanı hafif dokunma-basınç (semmes-weinstein
monoflament), iki nokta ayrımı (esthesiometer) ve vibrasyon (128-Hz diapozon) duyuları
bilateral olarak değerlendirildi. Diyabet hastalarının ayak tabanı hafif
dokunma-basınç, iki nokta ayrımı ve vibrasyon duyularının sağlıklı bireylere
göre azaldığı belirlendi (p<0,05). Kadın ve erkek diyabet hastalarının ayak
tabanı hafif dokunma-basınç, iki nokta ayrımı ve vibrasyon duyuları arasında
fark bulunmadı (p>0,05). Diyabetli hastalarda ayak tabanı hafif
dokunma-basınç, iki nokta ayrımı ve vibrasyon duyuları sağlıklı bireylere göre
azalmaktadır. Diyabetli hastalarda ayak tabanı duyusundaki azalma her iki
cinsiyette de benzerdir.

Anahtar Kelimeler

Diyabet, ayak tabanı, duyu, kadın, erkek

Kaynakça

• 1. http://www.who.int/mediacentre/factsheets/fs312/en/ (Erişim tarihi: 8 Aralık 2017) 2. http://www.diabetcemiyeti.org/c/diyabet-istatistikleri. (Erişim tarihi: 8 Aralık 2017) 3. Erbas T, Ertas M, Yucel A, Keskinaslan A, Senocak M, TURNEP Study Group. Prevalence of peripheral neuropathy and painful peripheral neuropathy in Turkish diabetic patients. J Clin Neurophysiol. 2011;28(1):51-55. 4. Schreiber AK, Nones CF, Reis RC, Chichorro JG, Cunha JM. Diabetic neuropathic pain: Physiopathology and treatment. World J Diabetes. 2015 15;6(3):432-444. 5. Veves A, Backonja M, Malik RA. Painful diabetic neuropathy: epidemiology, natural history, early diagnosis, and treatment options. Pain Med 2008; 9: 660-674. 6. O'Brien PD, Sakowski SA, Feldman EL. Mouse models of diabetic neuropathy. ILAR J. 2014;54(3):259-272. 7. Boulton AJ, Kirsner RS, Vileikyte L. Clinical practice. Neuropathic diabetic foot ulcers. N Engl J Med 2004; 351: 48-55. 8. Duby JJ, Campbell RK, Setter SM, White JR, Rasmussen KA. Diabetic neuropathy: an intensive review. Am J Health Syst. Pharm 2004; 15: 160-73. 9. Monteiro-Soares M, Boyko EJ, Ribeiro J, Ribeiro I, Dinis- Ribeiro M. Risk stratification systems for diabetic foot ulcers: a systematic review. Diabetologia 2011; 54: 1190-1199. 10. Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: US Department of Health and Human Services; 2014. 11. Nather A, Bee CS, Huak CY, Chew JL, Lin CB, Neo S, et al. Epidemiology of diabetic foot problems and predictive factors for limb loss. J Diabetes Complications 2008; 22: 77-82. 12. Van Houtum WH, Lavery LA, Harkless LB. The impact of diabetes-related lower-extremity amputations in The Netherlands. J Diabetes Complications. 1996;10: 325-330. 13. Fosse S, Hartemann-Heurtier A, et al. Incidence and characteristics of lower-limb amputations in people with diabetes. Diabetic Medicine. 2009; 26: 391-396. 14. Vuorisalo S, Venermo M, Lepantalo M. Treatment of diabetic foot ulcers. J Cardiovasc Surg 2009; 50: 275-291. 15. Kumar S, Fernando DJ, Veves A, Knowles EA, Young MJ, Boulton AJ. Semmes-Weinstein monofilaments: a simple, effective and inexpensive screening device for identifying diabetic patients at risk of foot ulceration. Diabetes Res Clin Pract. 1991; 13: 63-67. 16. Boyko EJ, Ahroni JH, Stensel V, Forsberg RC, Davignon DR, Smith DG. A prospective study of risk factors for diabetic foot ulcer. The Seattle Diabetic Foot Study. Diabetes Care. 1999; 22:1036-1042. 17. National Collaborating Centre for Primary Care: Clinical Guideline 10. Type 2 diabetes: Prevention and management of foot problems. National Institute for Clinical Excellence, London; 2004. 18. Frykberg RG, Lavery LA, Pham H, Harvey C, Harkless L, Veves A. Role of neuropathy and high foot pressures in diabetic foot ulceration. Diabetes Care. 1998; 21: 1714-1719. 19. Rubin RR. Psychotherapy and Counselling in Diabetes Mellitus. In: Snoek FJ, Skinner TC, editor. Psychology in Diabetes Care. Chichester: John Wiley & Sons Ltd; 2000.pp. 235-263. 20. Thomson MP, Potter J, Finch PM, Paisey RB. Threshold for detection of diabetic peripheral sensory neuropathy using a range of research grade monofilaments in persons with Type 2 diabetes mellitus J Foot Ankle Res. 2008; 1: 9. 21. Aaberg ML, Burch DM, Hud ZR, Zacharias MP. Gender differences in the onset of diabetic neuropathy. Journal of Diabetes and Its Complications. March, 2008. Volume 22, Issue 2: 83-87. 22. Booya F, Bandarian F, Larijani B, Pajouhi M, et al. Potential risk factors for diabetic neuropathy: a case control study. BMC Neurology. 2005; 5: 24. 23. Bansal D, Gudala K, Muthyala H, Esam HP, et al. Prevalence and risk factors of development of peripheral diabetic neuropathy in type 2 diabetes mellitus in a tertiary care setting. Journal of Diabetes Investigation. 2014; 5; 714-721. 24. Jerosch-Herold C. Assessment of sensibility after nerve injury and repair: a systematic review of evidence for validity, reliability and responsiveness of tests. J Hand Surg Br 2005; 30: 252-264. 25. Thomson MP, Paisey RP, Frost J, Potter J, Taylor P, Bower L. Sensory testing of feet in subjects without diabetes mellitus as a baseline for neuropathy studies. British Journal of Podiatry. 2001; 4: 49-52. 26. Nolan MF. Limits of two-point discrimination ability in the lower limb in young adult men and women. Phys Ther 1983; 63: 1424–1428. 27. Dellon AL, Mackinnon SE, Crosby PM. Reliability of two-point discrimination measurements. J Hand Surg Am 1987; 12: 693-696. 28. Temlett JA. An assessment of vibration threshold using a biothesiometer compared to a C128-Hz tuning fork. J Clin Neurosci 2009; 16: 1435–1438. 29. Buchman AS, Wilson RS, Leurgans S, Bennett DA. Vibratory thresholds and mobility in older persons. Muscle Nerve 2009; 39: 754-760. 30. Akseki D, Erduran M, Ozarslan S, Pinar H. Parallelism of vibration sense with proprioception sense in patients with patellofemoral pain syndrome: a pilot study. Eklem Hastalik Cerrahisi 2010; 21: 23-30. 31. Wandell PE, Gafvels C. Patients with type 2 diabetes aged 35–64 years at four primary health care centres in Stockholm County, Sweden. Prevalence and complications in relation to gender and socio-economic status. Diabetes Res Clin Pract, 63 (2004), pp. 195-203. 32. Wändell PE, Carlsson AC. Gender differences and time trends in incidence and prevalence of type 2 diabetes in Sweden--a model explaining the diabetes epidemic worldwide today?. Diabetes Res Clin Pract. 2014; 106: e90-92. 33. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004; 27: 1047-1053 34. Oyer DS1, Saxon D, Shah A. Quantitative assessment of diabetic peripheral neuropathy with use of the clanging tuning fork test. Endocr Pract. 2007; 13: 5-10. 35. Periyasamy R, Manivannan M, Narayanamurthy VBR. Changes in two point discrimination and the law of mobility in diabetes mellitus patients. J Brachial Plex Peripher Nerve Inj. 2008 Jan 29; 3: 3. 36. Rinkel WD, Castro Cabezas M, Setyo JH, Van Neck JW, Coert JH. Traditional Methods versus Quantitative Sensory Testing of the Feet at Risk: Results from the Rotterdam Diabetic Foot Study. Plast Reconstr Surg. 2017; 139: 752-763. 37. Cheng WY, Jiang YD, Chuang LM, Huang CN, Heng LT, Wu HP, Tai TY, Lin BJ. Quantitative sensory testing and risk factors of diabetic sensory neuropathy. J Neurol. 1999; 246: 394-398. 38. Cheong J, Alexiadou K, Senan Devendra. Absent monofilament sensation in a type 2 diabetic feet. London J Prim Care (Abingdon). 2017; 9: 73-76. 39. https://www.niddk.nih.gov/health-information/ diabetes/overview/preventing problems/nerve-damage-diabetic-neuropathies (Erişim tarihi: 6 Aralık 2017)